NPIMap

Organization Active NPI

Clarksville Health System GP

Doing business as Gateway Health System

  • Durable Medical Equipment & Medical Supplies
  • Clarksville, TN
National Provider Identifier
1861431652
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0000000623 Issued in TN
Legal business name
CLARKSVILLE HEALTH SYSTEM GP
Doing business as
Gateway Health System
Practice address
1760 Madison St
Clarksville, TN 37043-4913
Phone
(931) 552-6622
Fax
(931) 551-1027
NPI assigned
Jun 6, 2006
Last updated
Mar 7, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
CLARKSVILLE HEALTH SYSTEM GPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Laurie Holtsford
Title
Director of Business Office Support
Phone
(615) 465-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0000000623 TN Primary

Addresses

Primary practice location

1760 Madison St
Clarksville, TN 37043-4913

Mailing address

PO Box 403765
Atlanta, GA 30384-3765
Phone (931) 552-6622

Other identifiers 1

IdentifierTypeStateIssuer
1454419MedicaidTN

Other names 1

  • Gateway Health System Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clarksville Health System GP3 organizations share this tax ID, including this one
Part of
Clarksville Health System GP

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1760 Madison St
Clarksville, TN 37043
Phone (931) 552-6622

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1861431652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 403765",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303843765",
            "telephone_number": "931-552-6622",
            "fax_number": "931-551-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 MADISON ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434913",
            "telephone_number": "931-552-6622",
            "fax_number": "931-551-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSVILLE HEALTH SYSTEM GP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLARKSVILLE HEALTH SYSTEM GP",
        "enumeration_date": "2006-06-06",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "HOLTSFORD",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OFFICE SUPPORT",
        "authorized_official_telephone_number": "615-465-7000"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "0000000623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1454419",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.